Blood pressure is continually changing depending on activity, temperature, diet, emotional state, posture, physical state, and medication use.

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1 Blood Pressure Test Blood pressure is a measurement of the force applied to the walls of the arteries as the heart pumps blood through the body. The pressure is determined by the force and amount of blood pumped, and the size and flexibility of the arteries. Blood pressure is continually changing depending on activity, temperature, diet, emotional state, posture, physical state, and medication use. Equipment required: blood pressure cuff, stethoscope. Procedure: The pressure meter is placed on a bench where the subject cannot see the reading. Blood pressure is recorded after the subject has rested quietly for 5 minutes, and this measure should precede all other measures. The subject is seated with the arm resting on the bench, the elbow approximately at the level of the heart. The cuff is attached, the pressure then increased to approximately 180 mm Hg. The stethoscope is placed over the brachial artery in the cubital fossa. The pressure is released at a rate of approximately 2 mm per second. The pressure at which the first sounds are heard (systolic pressure) and the pressure when all sounds disappear (diastolic pressure) are recorded. Measurement: Blood pressure is recorded in the units of millimeters of mercury (mm Hg). Normal blood pressure is usually considered to be 120 for systolic and 80 for diastolic pressure - the same for both men and women. Medical treatment should be sought if measurements in the high category are recorded consistently. acceptable borderline high Systolic < > 160 Diastolic < > 95 Australian National Heart Foundation recommendations Comments: It is common for blood pressure to be elevated in stressful conditions (sometimes called 'white coat fever'), and therefore when someone is tested at a doctor's office they may have an unusually elevated blood pressure. When this is suspected, the test should be repeated after they have been given a time to rest, or in another less stressful place.

2 Body Mass / Weight Purpose: measuring body mass can be valuable for monitoring body fat or muscle mass changes, or for monitoring hydration level. Equipment required: Scales, which should be calibrated for accuracy using weights authenticated by a government department of weights and measures. Procedure: the person stands with minimal movement with hands by their side. Shoes and excess clothing should be removed. To improve reliability, weigh routinely in the morning (12 hours since eating).. If you are monitoring changes in body mass, try and weigh at the same time of day, under the same conditions, and preferably with no clothes on. Always compare using the same set of scales. Advantages: quick and easy measurement when testing large groups, with minimal costs. Disadvantages: measuring weight can be used as a measure of changes in body fat, but as it does not take into account changes in lean body mass it is better to use other methods of body composition measurement. Body weight can be affected by fluid in the bladder, the amount of food recently eaten, hydration level, the amount of waste recently expelled from the body, recent exercise and clothing, always try and weight under the same conditions.

3 Body Mass Index (BMI) Body Mass Index (BMI) is a measure of body composition, showing the relationship between weight and height. The higher the figure the more overweight you are. Like any of these types of measures it is only an indication and other issues such as body type and shape have a bearing as well. Remember, BMI is just a guide - it does not accurately apply to elderly populations, pregnant women or very muscular athletes such as weightlifters. Equipment required: scales and stadiometer as for weight and height. Procedure: BMI is calculated from body mass (M) and height (H). BMI = M / (H x H), where M = body mass in kilograms and H = height in meters. The higher the score, usually indicating higher levels of body fat. Scoring: Use the table below to determine your BMI rating. You can also use an ideal height and weight graph. Men Women underweight < 20 < 19 healthy range overweight obese > 30 > 30 Advantages: simple calculation from standard measurements Disadvantages: BMI can be inaccurate, for example with muscular athletes, rating them as obese due to lean tissue mass. Other simple measures of body composition, such as skinfolds measures, would be preferable if available.

4 Girth / Circumference Measures Girths are circumference measures at standard anatomical sites around the body, measured with a tape measure. Girth measurements can be used in determining body size and composition, and to monitor changes in these parameters. Equipment required: flexible metal tape measure. If a plastic or cloth tape is used, it should be checked regularly against a metal tape as others may stretch over time. Procedure: When recording, you need to make sure the tape is not too tight or too loose, is lying flat on the skin, and is horizontal. For descriptions of the procedure for measuring specific girths see the list below. Validity: Girth measurements are sometimes used as a measure of body fat, but is not a valid predictor of this. They are however a good measure of proportionality. Reliability: Things that may affect reliability are changes to the testers, constant and even tension on the tape, and correct landmarking (finding the correct anatomical sites for measurement). Advantages: low costs involved in the testing procedure, and for many sites the measurement can be self administered. Other comments: Girth measurements combined with skinfold measurements can give a clearer picture of changes in muscle and fat compositions and distribution. A common girth measure is the waist measure, used in determining waist to hip ratio (WHR). Clothing over the site should be removed if possible to make sure measuring tape is positioned correctly and that the correct circumference is determined. Sites: Below are some common sites used for girth measurements.

The arm is relaxed and hanging by the side, and the circumference is taken at the level of the mid-point between the acromial (boney point of shoulder) and the olecranon (boney point of elbow)

5 Arm Relaxed Girth Aim: To measure the circumference of the arm, as a measure of the underlying musculature and adipose tissue. Procedure: This girth measurement is usually taken on the right side of the body. The arm is relaxed and hanging by the side, and the circumference is taken at the level of the mid-point between the acromial (boney point of shoulder) and the olecranon (boney point of elbow) processes. Arm Flexed Girth Aim: To measure the circumference of the arm, as a measure of the underlying musculature and adipose tissue and also arm hypertrophy. Procedure: This girth measurement is usually taken on the right side of the body. The arm is raised to a horizontal position in the sagittal (forward) plane, with the elbow at about 45 degrees. The subject maximally contracts the biceps muscle, and the largest circumference is measured. The maximal girth is not always obvious, and the tape may need to be moved along to find the point of maximum circumference.

After the tape is in position, the arms should be relaxed by the side, and the measurement taken at the end of a normal expiration.

6 Chest Girth Aim: To measure the circumference of the chest, as a measure of the chest muscles and lung size. Procedure: This measure is taken at the level of the middle of the sternum (breast-bone), with the tape passing under the arms. After the tape is in position, the arms should be relaxed by the side, and the measurement taken at the end of a normal expiration. For this girth measurement, due to the location, care should be taken to maintain personal privacy of the subject, and sometimes it is appropriate to measure over clothing. If so, this should be recorded with the results. Waist or Abdominal Girth Aim: the purpose of determining waist girth is to gain a measure of the amount of abdominal fat (visceral fat), which has been linked to increased risk of coronary heart disease and diabetes. Procedure: The waist measurement is taken at the narrowest waist level, or if this is not apparent, at the mid point between the lowest rib and the top of the hip bone (illiac crest). If you are unsure if this measurement was taken at the narrowest level, take several measurements at different levels and take the lowest measurement. Some procedures measure abdominal circumference at the level of the umbilicus (belly-button), such as for the Navy PRT.

7 Men Women Scoring: Risk cm inches cm inches Very High > 120 > 47 > 110 > 43.5 High Source: ACSM (2005) ACSM guidelines for Low Very Low < < < < 28.5 exercise testing and prescription, 7th ed. Lippincott, Williams, and Wilkins, 61 Validity: The health risk may not be accurate in those individuals with thick waist musculature or those that are particularly tall or short. For women who deposit fat primarily lower on the body (hips, buttocks, and thighs), waist measurements in isolation have a poor relationship with health factors. references: Björntorp P (1992). Abdominal fat distribution and the metabolic syndrome. J Cardiovasc Pharmacol : 20 Supp 8: S26-S28. Pouliot M-C, Després JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ. (1994). Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardio. 73: Welborn TA, Satvinder S Dhaliwal and Stanley A Bennett (2003). Waist hip ratio is the dominant risk factor predicting cardiovascular death in Australia. The Medical Journal of Australia; 179 (11/12):

minimal clothing, at the level of the greatest protrusion of the gluteal (buttock) muscles.

8 Hip Girth Aim: to measure the circumference of the hip area, as a measure of the underlying hip structure, musculature and adipose tissue. When combined with the measure of abdominal girth in the Waist-Hip Ratio (WHR), has been shown to be related to the risk of coronary heart disease Procedure: The hip girth measurement is taken over minimal clothing, at the level of the greatest protrusion of the gluteal (buttock) muscles. The subject stands erect with their weight evenly distributed on both feet and legs slightly parted, making sure not tense the gluteal muscles. For this girth measurement, due to the location of the measure, care should be taken to maintain personal privacy of the subject, and sometimes it is appropriate to measure over clothing. If so, this should be recorded with the results. Scoring references: Welborn TA, Satvinder S Dhaliwal and Stanley A Bennett (2003). Waist hip ratio is the dominant risk factor predicting cardiovascular death in Australia. The Medical Journal of Australia; 179 (11/12):

Mid Thigh Girth Aim: To measure the circumference of the thigh, as a measure of the underlying musculature and adipose tissue. Procedure: First mark the site to be measured.

9 Mid Thigh Girth Aim: To measure the circumference of the thigh, as a measure of the underlying musculature and adipose tissue. Procedure: First mark the site to be measured. This girth measurement is usually taken on the right side of the body. The subject stands erect with their weight evenly distributed on both feet and legs slightly parted. The circumference measure is taken at the level of the mid-point on the lateral (outter side) surface of the thigh, midway between trochanterion (top of the thigh bone, femur) and tibiale laterale (top of the tibia bone). 1 mile / 1.6 km Run Test This is a test of aerobic fitness, an important component of endurance based and team sports. The 1.6 km endurance run is part of the etid Talent Identification Testing Program, and their protocol is listed here. One mile = kilometers. See also a description of another 1-mile /run test and the 1-mile walk test. Purpose: This test measures aerobic fitness and leg muscles endurance. Equipment required: Set treadmill distance to 1.6 km elevation 0, stopwatch. Procedure: The aim of this test is to complete a 1.6 kilometer in the shortest possible time. At the start, all participants are set-up on their treadmills. On the command go, press quick start and the clock will start, and the athletes begin running at their own pace. Scoring: The total time to complete the course is recorded for each participant, in minutes and seconds. Advantages: large groups of athletes can be tested at once, and it is a very cheap and simple test to perform. Disadvantages: practice and pacing is required, and performance on this test can be affected greatly by motivation.

10 Push Up Test The push-up fitness test (also called the press up test) measures upper body strength and endurance. There are many variations of the test, such as different placement of the hands, how far to dip, the length of the test and the method of counting. Equipment required: depending on which protocol you use, you will need a floor mat, metronome (or audio tape, clapping, drums), stopwatch Procedure: A standard push up begins with the hands and toes touching the floor, the body and legs in a straight line, feet slightly apart, the arms at shoulder width apart, extended and at a right angles to the body. Keeping the back and knees straight, the subject lowers the body to a predetermined point, to touch some other object, or until there is a 90-degree angle at the elbows, then returns back to the starting position with the arms extended. This action is repeated, and test continues until exhaustion, or until they can do no more in rhythm or have reached the target number of push-ups Scoring: Record the number of correctly completed push-ups

11 Curl Up / Sit-Up / Crunch Test This is a general description of a sit up test to measure abdominal muscle endurance. The procedures and technique can vary depending on which specific test you are performing. See the procedures for links to test instructions for specific abdominal endurance tests. Purpose: The curl up test measures abdominal muscular strength and endurance of the abdominals and hip-flexors, important in back support and core stability. Equipment required: flat, clean, cushioned surface, stopwatch, recording sheets, pen. Some variations will also require the following: curl up strips, a tempo device (a metronome, drums, a sit up beep test mp3, the PACER test cd which includes cadences for a sit up test). Sit-up technique: Described here are the commonly used methods and some general guidelines. The subject lies on a cushioned, flat, clean surface with knees flexed, usually at 90 degrees. Some techniques may specify how far the feet are from the buttocks, such as about 12 inches. A partner may assist by anchoring the feet to the ground. The position of the hands and arms can affect the difficulty of the test. They are generally not placed behind the head as this encourages the subject to stress the neck and pull the head forward. The hand may be placed by the side of the head, or the arms crossed over the chest, reaching out in front. Some protocols use curl up strips or other marks on the ground to slide the hands along and indicate how much to curl up. The subject raises the trunk in a smooth motion, keeping the arms in position, curling up the desired amount. The trunk is lowered back to the floor so that the shoulder blades or upper back touch the floor.

12 Procedure: A common method of performing a sit up fitness test is to record the maximum number of sit ups in a certain time period, such as 30 seconds (Eurofit Sit Up Test), one minute (President's Challenge Curl Up Test, home sit up) or two minutes (e.g. in the US Army and US Marines and US Navy). Alternatively, the test may be performed at a set tempo, and the maximum number of total sit ups is recorded (Fitnessgram curl up, partial sit up test). For this method, a metronome may be set at the desired tempo, or a audio tape or cd with a recording of the pace may be used. The NCF Abdominal Curl Conditioning Test takes this a step further, and has a tempo test that progressively gets faster, much like the running beep test. It is important that the correct technique is used as described for accurate comparison to the norms. If using a variation of the test, the actual technique and procedure should be recorded with the results, and appropriate norm tables consulted. Scoring: The completion of one complete curl up (up and back) counts as one. The sit up must be performed correctly for it to be counted. For the tempo tests, the test is continued until the subject cannot maintain the rhythm or has reached the target number for the test. Advantages: this test is simple to perform requiring minimal equipment, and large groups may be tested at once. Disadvantages: a curl up with the feet held increases the involvement of the hip flexor muscles, making the test less valid as a measure of abdominal strength. It is sometimes difficult to determine if a correct sit up is performed, such as bouncing off the floor, and there may be dispute about the total number. When using the tempo method, the instructor should have clear guidelines of when they terminate the test

13 Wall Sit Test Purpose: to measure the strength endurance of the lower body, particularly the quadriceps muscle group. Equipment required: smooth wall and a stopwatch Procedure: Stand comfortably with feet approximately shoulder width apart, with your back against a smooth vertical wall. Slowly slide your back down the wall to assume a position with both your knees and hips at a 90 angle. The timing starts when one foot is lifted off the ground and is stopped when the subject cannot maintain the position and the foot is returned to the ground. After a period of rest, the other leg is tested. Scoring: the total time in seconds that the position was held for each leg is recorded. The table below gives a general guideline to expected scores for a single leg for adults, based on my personal experiences. Comparing the scores for each leg may indicate muscle weakness on one side. rating males (seconds) females (seconds) excellent >100 > 60 good average below average very poor < 25 < 20 Variations / alternatives: see also the single leg squat test, chair stand test and the home squat test. Advantages: This test requires minimal equipment and can be conducted with large groups all at once.

14 The 3 minute Step Test The 3-Minute Step Test measures your aerobic (cardiovascular) fitness level based on how quickly your heart rate returns to normal after exercise. Equipment needed: Stopwatch or clock with a second hand; a 12-inch bench box, or step; a metronome Purpose: To measure how quickly your heart rate returns to resting after 3 minutes of continuous exercise. Procedure: The test is based on a 12-inch step, so use one as close to 12 inches as possible, an aerobic step is ideal as you can adjust the height to fit the test. Set the metronome to 96 beats per minute and make sure you can hear the beat. Stand facing the step, then when you are ready to begin, start the clock or stopwatch and step up and down on the step to the metronome beat (up, up, down, down) for 3 consecutive minutes. (If the member cannot finish the test or scores at the Very Poor level, he/she should obtain medical clearance before further testing.) When 3 minutes are up, stop immediately, sit down on the step, and count your pulse (use your wrist or neck) for one full minute. Scoring: Here are the age-adjusted standards based on guidelines published by YMCA. Ratings for Men, Based on Age Excellent Good Above Average Average Below Average Poor Very Poor

15 Ratings for Women, Based on Age Excellent Good Above Average Average Below Average Poor Very Poor Guidelines: before conducting any fitness test, you should review each person's medical status to identify medical, orthopedic or other health problems that should be considered. Before starting, make sure the correct techniques for all tests are explained. (see the Fitness Testing Guidelines for more info)

Fitness Assessment Instructions

Fitness Assessment Instructions Read through the directions before completing each Fitness Assessment. Remember to print off your assignment sheet so you can record your scores. You will be transferring